POSITION DESCRIPTION
FUNCTIONAL TITLE: Case Manager
REPORTS TO: Director of Social Services
JOB CATEGORY III: Tasks that involve no exposure to blood, body fluids or tissues, and Category I tasks are not a condition for employment.
GENERAL DESCRIPTION
The Case Manager is selected by and is responsible to the Director of Social Services. The Case Manager is responsible for the following established operational procedures of the Social Services section. The Case Manager works under general supervision to establish communications with referred individuals, obtains pertinent information on patients as to the nature of their situations, consults with the immediate supervisor and/or provider to patient progress, facilitates financial assistance, travel provisions, home/hospital visitation and referrals to other agencies or individuals as requested, works closely with administrators, providers and staff to productively serve the user, patient and general public, processes NHHC outside referrals and related duties as assigned to achieve organizational goals and program objectives.
Case Managers function as a member of a collaborative health care team to create and maintain a Patient Centered Medical Home where emphasis is on excellent communication; support of the patient is provided and tracked in a culturally competent, behaviorally enhanced setting supported by information technology.
Due to the nature of NHHC services, it may become necessary to require employees to work extended hours or other variations of the usual shift to ensure adequate care of patients and provide services to the community.
CRITICAL JOB ELEMENTS/PERFORMANCE STANDARDS
I. Must be professional in dealing with patients and the public via personal and telephone contacts. Must use good listening skills at all times. Demonstrate positive attitude towards patients with good eye contact, pleasant voice, attentive and responsive to their needs.
II. Interviews the patient for (public assistance, etc.) counsels patients with emotional/economical and medical problems, and accurately documents utilizing the SOAP subjective, objective, assessment and planning.
1. Allowing for no more than zero to two inaccurate errors during the appraisal period as documented by the monthly department quality assurance audit.
III. Completes screenings for Social Drivers of Health, enters data into electronic medical records, and makes necessary referrals to community organizations that will assist patients meet their non-medical needs.
IV. Processes NHHC referrals out to physicians by NHHC physicians and processing social services referrals to other agencies when necessary.
1. Processes NHHC physicians referrals to outside physician/hospitals.
a. Maintains ninety percent follow-up ratio of NHHC referrals to outside physicians/hospitals.
b. Ensures that the patient shows up for consultation and orientates the patient on the case, etc.
c. Referrals are monitored through random audit of the Social Services Referral forms allowing for no more than zero to three errors during the appraisal period.
d. As part of the expanded roles and duties in PCMH, the Case Manager will track the referrals generated by the Provider assigned to Case Managers care team on a weekly basis to meet PCMH requirements.
V. Provides information with any available transportation assistance to patients referred to outside hospitals. When transportation funds are not available, the case manager will explore social agencies for possible funding assistance if deemed necessary.
VI. Serves as a Care Coordinator of all referral functions, ensuring proper coordination between providers and any applicable specialty service referrals provided to patients. The Care Coordinator will be responsible for patient appointment scheduling and follow up on referrals, as well as the development of an individualized care plans to support patients in accessing all needed family planning program services under the Family Planning Grant and ensure patients are connected to the appropriate resources.
VII. Follow-up on patients to ensure proper disposition of case at the Case Workers
discretion as monitored by the supervisors review of case load.
VIII. Must abide by dress code policy in order to maintain a professional and neat
appearance. (For details see Employee Handbook dress code policy).
IX. Must abide by the regulations, protocols, and policies as indicated in the BCHC
Employee Handbook, Code of Conduct, Safety policies, and PCMH Standards.
X. Ensures the protection and security of personal, confidential and identifiable information in a professional and responsible manner in accordance to standards and requirements under (HIPAA) Health Insurance Portability and Accountability Act.
XI. Participate in PCMH orientation to become knowledgeable on the model and to be ableto support the PCMH principles, policies, and procedures.
XII. Performs all duties to ensure that patients have a pleasant and satisfactory experience in
the manner in which their health care is delivered, managed, and coordinated with both
internal and external entities and in which the patient participates in the decision-
making.
XIII. In conjunction with the care team, Case Manager will assure that patients receive the services needed in order to maximize patient care in efforts to meet PCMH and NCQA requirements.
XIV. It is mandatory that the employee participate in Quality Performance Improvement projects aimed at improving patient care, outcomes, and efficiency as it pertains to PCMH Standards.
Allowing for no more than zero to three errors during the appraisal period as documented by the department supervisors daily audit of transportation log and departments monthly Quality Assurance Audit.
JOB SPECIFICATIONS
Education and Requirements:
A Bachelors Degree in Social Work or related field of Study.
Valid TX drivers license and available transportation to travel from site to site.
Experience:
One year experience as a Social Worker or Case Worker in a medical setting.
Knowledge, Skills, and Abilities:
One year experience as a Social Worker or Case Worker in a medical setting.
Knowledge, Skills, and Abilities:
Knowledge of local, social, economic conditions, interviewing and counseling skills.
Ability to communicate effectively both verbally and in writing in English and Spanish with staff and the general public.
Ability to interpret verbal and non verbal behavior, to develop accurate perception and understanding of others needs and opinions; to be sensitive to factors in a clinical environment.
Ability to establish and carry out specific courses of action.
Ability to take corrective action in solving problems, to identify dimensions of a problem, determines potential causes and specifies alternative solutions.
Ability to conform to established centers policies and procedures.
Ability to maintain a mature attitude while dealing with interpersonal conflict, disruptions, time demands, etc.
CPR-BLS certification must be kept current.
Physical Requirements: The essential function of this job does not require lifting more than 25 pounds.
